NPIMap

Organization Active NPI

Wurtland Nursing and Rehabilitation LLC

  • Skilled Nursing Facility
  • Wurtland, KY
National Provider Identifier
1750936621
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
WURTLAND NURSING AND REHABILITATION LLC
Practice address
100 Wurtland Ave
Wurtland, KY 41144-1445
Phone
(606) 836-0931
NPI assigned
Aug 7, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Paul Pruitt
Title
Officer
Phone
(317) 288-4029

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

100 Wurtland Ave
Wurtland, KY 41144-1445

Mailing address

100 Boulevard of Americas
Lakewood, NJ 08701-4585
Phone (732) 961-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191004002110 KY Part A Provider - Skilled Nursing Facility 6103157193 Practice locations: Wurtland, KY

Skilled nursing facility certification: CCN 185261

Legal name
WURTLAND NURSING AND REHABILITATION LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 8, 1991
Last certification
Feb 11, 2025
Beds
126
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
Jul 25, 2019 in IN
Enrollment address
100 Wurtland Ave
Wurtland, KY 41144-1445
Nursing home name
WURTLAND NURSING AND REHABILITATION
Affiliated entity
DAVID MARX

Care Compare: Nursing home

Medicare Care Compare
Listed as
Wurtland Nursing and RehabilitationCCN 185261
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
1 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Mar 8, 1991
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
126110.0 residents per day on average
Chain
David Marx10 facilities in the chain
Penalties (3 years)
2Fines totaling $69,908

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Locations

100 Wurtland Ave
Wurtland, KY 41144
Phone (606) 834-0144

Ownership & related parties

All disclosed owners & managing parties 17

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
David Alexander Individual Operational/Managerial Control May 1, 2023
Adp of the SNF May 1, 2023
Organization, Lakewood, NJ Consulting firm Adp of the SNF Sep 4, 2025
Organization, Flushing, NY LLC, Holding company Adp of the SNF Sep 1, 2019
Angela Rewa Individual Operational/Managerial Control Oct 23, 2023
Adp of the SNF Oct 23, 2023
Adam Rucker Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jan 1, 2025
Robert Laron Russell Individual Operational/Managerial Control Apr 8, 2024
Adp of the SNF Apr 8, 2024
Wurtland Nursing and Rehabilitation Holdings LLC Organization, Wurtland, KY LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jul 25, 2019 100%
Organization, Flushing, NY LLC, Holding company Adp of the SNF Sep 1, 2019
Paul Pruitt Individual Operational/Managerial Control May 1, 2023
Managing Control - Governing BodyCeo May 1, 2023
Adp of the SNF May 1, 2023
MDG Real Estate Global Limited Organization, Flushing, NY Corporation, Holding company Adp of the SNF Jun 1, 2019
Bluegrass Consulting Group LLC Organization, Westfield, IN LLC, Management services company Operational/Managerial Control Sep 1, 2019
Adp of the SNF Sep 4, 2025
Margaret Chamberlain Individual Operational/Managerial Control Sep 11, 2023
Adp of the SNF Sep 11, 2023
Anzhelika Shatrov Individual Operational/Managerial Control Dec 2, 2024
Adp of the SNF Dec 2, 2024
David Marx Individual 5% Or Greater Indirect Ownership Interest Jul 25, 2019 100%
Kari D Shields Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jan 1, 2025
100 Wurtland Ave SNF Realty LLC Organization, Flushing, NY LLC Operational/Managerial Control Sep 1, 2019
Adp of the SNF Sep 1, 2019
Eric Wolfe Individual Operational/Managerial Control Sep 11, 2023
Adp of the SNF Sep 11, 2023

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 8

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1565136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689811200000",
    "number": "1750936621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BOULEVARD OF AMERICAS",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087014585",
            "telephone_number": "732-961-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WURTLAND AVE",
            "city": "WURTLAND",
            "state": "KY",
            "postal_code": "411441445",
            "telephone_number": "606-836-0931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WURTLAND NURSING AND REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-07",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A",
        "authorized_official_last_name": "PRUITT",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "317-288-4029"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wurtland, KY

Sources for this page

Verify at the official NPI Registry.